The Usefulness of 18F-FDG PET as a Cancer Screening Test.
- Author:
Doo Heun KO
1
;
Joon Young CHOI
;
Yun Mi SONG
;
Su Jin LEE
;
Young Hwan KIM
;
Kyung Han LEE
;
Byung Tae KIM
;
Moon Kyu LEE
Author Information
1. Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cancer screening;
positron emission tomography;
18F-fluorodeoxyglucose
- MeSH:
Adenocarcinoma;
Colonic Neoplasms;
Early Detection of Cancer;
Female;
Fluorodeoxyglucose F18;
Follow-Up Studies;
Humans;
Male;
Melanoma;
Positron-Emission Tomography;
Prostatic Neoplasms;
Sensitivity and Specificity;
Stomach Neoplasms;
Thyroid Neoplasms;
Urinary Bladder Neoplasms;
Urologic Neoplasms
- From:Nuclear Medicine and Molecular Imaging
2008;42(6):444-450
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) for cancer screening in asymptomatic subjects. MATERIALS AND METHODS: The subjects were 1,762 men and 259 women who voluntarily underwent 18F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. RESULTS: Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal 18F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. CONCLUSION: 18F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.
